Atherosclerotic Cardiovascular Disease Among Patients with Type 2 Diabetes: A Comparison Based on Peripheral Blood Inflammatory Marker Levels (SIL, PLR, NLR). A systematic review of reported incidence.

Medical (Internal Medicine Endocrinology )

Background: Atherosclerotic cardiovascular disease (ASCVD) is a major cause of morbidity and mortality among individuals with Type 2 Diabetes Mellitus (T2DM). Chronic inflammation plays a crucial role in the development of both T2DM and cardiovascular diseases. Inflammatory markers such as Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and the Systemic Immune-Inflammation Index (SII) have been suggested as potential biomarkers for cardiovascular risk in diabetic patients. This systematic review aims to assess the incidence of ASCVD and the relationship between NLR, PLR, and SII levels and ASCVD in T2DM patients. Methods: A systematic review of studies published between 2010 and 2024 was conducted by searching PubMed, Embase, and Cochrane Library databases. Studies were included if they examined the association between NLR, PLR, or SII or ASCVD outcomes in T2DM patients, such as ischemic heart disease (SIHD), diabetic retinopathy (DR), or coronary artery disease (CAD). The quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS), and relevant data such as study design, sample size, participant demographics, and statistical methods were extracted. The findings from eligible studies were summarized using a narrative synthesis. Results: A total of 12 studies were included in the review. The review found that the burden of ASCVD among T2DM patients is significantly high ranging between 16% to 46%. The review found that higher levels of NLR were significantly associated with an increased risk of ASCVD in T2DM patients. Similarly, elevated PLR and SII were also linked to a higher risk of ASCVD. Conclusion: The burden of ASCVD among T2DM patients is high. Elevated levels of NLR, PLR, and SII are consistently associated with an increased risk of ASCVD in T2DM patients. These inflammatory markers can serve as useful tools for predicting cardiovascular complications and identifying high-risk diabetic patients early. However, the variability in study designs and populations indicates the need for further large-scale, long-term studies to confirm these findings and explore their clinical relevance in everyday practice.

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.